R 2013-195 AMS - MBAJ Architects, Ins NHSC Architrectural & Engineering Design/Construction

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o?Or3- l�5 ORANGE COUNTY-CONTRACT CONTROL SHEET Routing Order: (1)Department,(2)IT,(3)Risk Management,(4)Financial Services,(5)Attorney,(6)Manager,(7)Clerk This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. If the Manager determines the contract is not appropriate for Manager approval the Manager shall submit the cont-act for BOCC approval. Contracts for BOCC approval must be submitted through,and complete,the routing process prior to agenda review. Contracts for legal review should be completed through the legal review process prior to being routed fo-signature. Department PartyNendor Name: MBAJ Architects,Inc. PartyNendor Contact Person: John Thomas Contac:Phone:9191-573-6400 PartyNendor Address: 9131 Anderson Way, Suite 204 City Raleigh State:NC Zip:27615 Department:AMS Amount: 173,500 P}l'rpose: Architrectural and Engineering-Design/Construction Administration professional services for the Northern Hu an Seivices Center community center capital project Budget Code(s):617370035-870000-10016 Vendor#N/A (N/A if ne�n or) Vendor is a BOCC consultant? Yes❑No® Contract Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date 6/20/13 Approved by Board Yes®No❑ Agenda Date: 6/18/13 Title of Contract:NHSC Design If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners Yes❑No❑. If submitted for bid were bids/RFPs received Yes®No❑ Bid/RFP number 5191This contract has been reviewed and approved by the Department Director as to technical content: Department Director's Signature: Z C �' Date: IT Dire or (Applicable only to hardware/software purchases or related se ices) his contract has been reviewed and approved by the Information Technology Director as to technical content and information tec ogy specifications: IT Director's Signature: Date: Risk Management Include the following coverages: [/CGL; [Auto; 9 WC; ❑ Professional; [!f Property; OR No Insurance Required ❑. Hold Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shown,this contract is approved by the Risk Manager: ` Risk Manager's Signature:Aaa-w A � Date: Financial Services i This Contract is conditioned}�pon appropriation by the Board of Commissioners Yes❑No . A budget amendment is necessary before approval Yes❑No❑+r. If budget amendment is necessary,please attach to this form. This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Acct: Financial Services Director's Signature: NQt.� hV.-, Date: 6121413 County Attorney Approval by Board ❑ (Contracts $90,000.00 or more for goods or services, $250,000.00 or more for construction, or any BOCC consultant contract). Approval by Manager'❑(Most other contracts$1,000 and above). Department Director approval only❑ (Under $1,000). This contract has been reviewed and approved by the Attorney as to legal form and sufficiency: Attorney's Signature Date: County Manager This contract has been reviewed and is approved by the Coun ager Yes0 El. This contract has been reviewed and is for signatuabe Yes❑No�Manager's Signature: Date: qLff- to the Board Approved by BOCC on the_day of ,20 . Submitted for Chair signature on the day of 20 Clerk's Signature: Date: Revised March 2012